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Elbow: Tingling and Numbness

I have numbness and pins-and-needles in my left forearm. The first time it happened was last March while climbing in the Red, and it happened again this past June at Smith Rock. Both times I didn't notice anything until I was finished with the route. When I got down, it felt like a big rubber band was being tightened from the tips of my fingers through to the top of my elbow. My belayer squeezed my arm for about 15 minutes and the pain subsided, but the numbness and prickling won't go away. If I run my thumb down my forearm I feel tingling on the underside and in my thumb. Any ideas?

Rachel | Bend, OR

That you are suffering a compromised radial nerve requires fewer brain cells than picking boogers.

There are a few variations on this genre. Damage in your upper arm from a humeral fracture is the most common, but I suspect a broken wing would prohibit climbing in the Motherlode! Next in line is entrapment of a branch of the radial nerve called the posterior interosseus nerve. You haven't mentioned loss of grip strength so this is also unlikely, albeit in the right area -- your elbow.

Though it sounds like something you would catch at the Berlin Love Parade, Wartenberg Syndrome is far less titillating. Named after an astute German neurologist, this nerve-compression syndrome involves a small superficial sensory branch of the radial nerve as it passes between two muscles near your elbow (brachioradialis and extensor carpi radialis longus).

Nerves carrying sensory fibers can be compressed around the elbow in other sites, but all will usually be accompanied by weakness when there is a sensory loss. Although there are other purely sensory nerves, their entrapment and your description don't correlate well. Keep in mind that the nerve supply through the forearm and hand is a complete Charlie Foxtrot and, like hair distribution, tends to vary a little.

It sounds like the nerve, at least while you are really pumped, is being squeezed harder than Fannie Mae. The rubber band tightness should be worse if you grip your thumb in a fist, turn your palm toward the ground and bend your wrist toward your little finger (De Quervain's test).

Your best bet is to have a therapist brutalize your forearm (especially from above the elbow on the outside and down toward your thumb) to the point that plucking your bikini line with forceps would be a more enjoyable pastime. Within reason, you can't really do more damage than the nerve has already been subjected to.

Try the brachioradialis stretch that is described in Dodgy Elbows [No. 156 or drjuliansaunders.com], but with your thumb tucked into your palm. It will hurt and, like so many others, you will curse me.

Though it does not sound like a blood supply issue, it could be. Though it does not sound like a tumor it could be. So if it does not settle reasonably quickly, go and see zee doktor. A nerve conduction study, blood flow ultrasound and MRI might be the order of the day. Along with a nice vino tinto.